Padberg F T, Lee B C, Curl G R
Department of Veterans Affairs Medical Center, East Orange, New Jersey 07019.
Surg Gynecol Obstet. 1992 Feb;174(2):103-8.
Infectious complications involving a hemoaccess graft or fistula are a significant cause of morbidity in patients on chronic hemodialysis. A review of 274 consecutive hemoaccess procedures identified 28 infections (an incidence of 10 per cent). Infections occurred in 27 polytetrafluoroethylene (PTFE) grafts. The predominant organism was Staphylococcus aureus. Partial excision resolved 14 of the 27 graft infections. The remaining 13 required complete removal. Surgical management required six arterial ligations and seven autogenous reconstructions. No limb ischemia or mortality was directly attributable to these procedures. One infection occurred in 48 autogenous fistulas (an incidence of 2 per cent). Although partial removal of an infected prosthesis was often sufficient, brachial artery ligation was well tolerated when required to control anastomotic infection.
涉及血液透析通路移植物或动静脉内瘘的感染并发症是慢性血液透析患者发病的重要原因。对连续274例血液透析通路手术进行回顾性研究，发现28例感染（发生率为10%）。27例感染发生在聚四氟乙烯（PTFE）移植物中。主要病原体是金黄色葡萄球菌。27例移植物感染中有14例通过部分切除得到解决。其余13例需要完全移除。手术处理需要6次动脉结扎和7次自体血管重建。这些手术没有直接导致肢体缺血或死亡。48例自体动静脉内瘘中有1例发生感染（发生率为2%）。虽然感染假体的部分切除通常就足够了，但在控制吻合口感染需要时，结扎肱动脉耐受性良好。
